The Concept of Relationships and De-escalation: Safe De-escalation Training

Lene Lauge Berring, Gitte Ranfelt Laugesen, Demi Hansen, Rikke Juhl, Trine Marita Bjerre, Annette Winkel

Research output: Contribution to conference without publisher/journalPosterResearchpeer-review


Abstract to a poster presentation Horatio 2019

The Concept of Relationships and De-escalation: Safe De-escalation Training


Coping with and understanding agitated, violent and threatening behaviour in mental health care settings is a challenging, but integral part of a caregiver’s job. If not handled well, such situations can result in staff and patient injuries. Moreover, frequent staff exposure to violence can be a traumatic experience and can cause several problems in the workforce such as an intend to leave the profession and secondary traumatic stress in staff recognized as anxiety and sleep disturbance (Lanctôt and Guay, 2014). Though, there is no consensus about what kind of training caregivers need in order to create safe environments.

The ‘Concepts of Relationships and de-escalation’ is a new paradigm of violence prevention. It was co-created in a joint venture between managers, staff members and service users and includes organisational strategies that moves the discussion away from blaming staff members towards identifying the structural and organizational roots of workplace violence. It has a person-centred value-based approach to care and aim to improve the safety of all patient and staff by addressing underlying risk factors that increase the likelihood that an individual will become a victim or a perpetrator of violence. It arises from the public health perspective and contains a series of inter- related targeted preventive activities designed to prevent violence on the primary, secondary and the tertiary level. The program was implemented from 2016 – 2019. All new employees participate in the three days training course followed by two days of repetition.
In order to identify how the training program helped staff members to deal with workplace violence, questionaries’ was distributed immediately after the course and three months later.

Preliminary results
Data from 2018 was analysed using multivariate regressions in Stata. Data collection were conducted using survey exact. Approximately 60 % of participants responded (N= 390). Several benefits of the training program were derived such as participant felt prepared to work and they appreciated the person-centred value-based approach. Moreover, did staff members mostly report (after 3 month), that the program promoted safety for staff members and patients. Differences were seen in the concept impact (age difference and speciality differences).

Addressing underlying risk factors that increases the likelihood that an individual will become a victim or a perpetrator, demand deep cultural changes. Even though staff members reported enhanced safety, the implementation still needs to show whether this public health inspired training approach influence work injuries, staff turnover and the use of coercive measures.

Learning outcome
• The participants will gain knowledge about the Concept of Relationships and de-escalation
• The participants will discuss the preventive activities designed to reduce the level of interpersonal violence
• The participants will reflect upon cultural changes in organisations when implementing a violence preventing program founded in the public health perspective
Translated title of the contributionPsykiatriens Koncept for Relationer og Deeskalering: Tryg deeskalerings træning
Original languageEnglish
Publication date22. Oct 2019
Publication statusPublished - 22. Oct 2019
EventViolence in clinical psychiatry: 11 th. European Congress - Thon Hotel Arena, Lillestrøm, Norway
Duration: 24. Oct 201926. Oct 2019


ConferenceViolence in clinical psychiatry
LocationThon Hotel Arena

Cite this